Matot I, Jurim O
Department of Anesthesiology and CCM, Hadassah University Medical Center, The Hebrew University of Jerusalem, Israel.
Anesth Analg. 2001 Mar;92(3):590-5. doi: 10.1097/00000539-200103000-00007.
The purine precursor acadesine is highly effective in preventing ischemia-reperfusion (I-R) injury of the heart and intestine. The aim of this study was to test the effect of acadesine on I-R--induced lung injury. The lobar artery of the left lower lung lobe in intact-chest, spontaneously breathing cats was occluded for 2 h (Group 1, ischemia) and reperfused for 3 h (Group 2, I-R). Animals were subjected to one of the following three protocols: acadesine administered IV 15 min before ischemia (Group 3), 15 min before reperfusion (Group 4), or 30 min after reperfusion (Group 5). Acadesine was administered at an initial dose of 2.5 mg. kg(-1). min(-1) for 5 min, followed by 0.5 mg. kg(-1). min(-1) until the end of reperfusion. Injury was assessed by histologic examination. The right lower lobe served as control. Compared with the right lower lobe, which showed no abnormal findings in any group (percentage of injured alveoli, 2% +/- 1% to 4% +/- 2%), the left lower lung lobe in the I-R group revealed a disrupted alveolar structure with 63% +/- 9% injured alveoli. Ischemia alone did not produce alterations in alveolar structure. Acadesine significantly reduced the number of injured alveoli when given before ischemia (4% +/- 1%) or reperfusion (6% +/- 2%) but not when administered after reperfusion (62% +/- 8%). In conclusion, acadesine, when administered before ischemia or reperfusion, can blunt I-R-induced lung injury. The mechanism underlying the protection remains to be elucidated.
Acadesine reduces ischemia-reperfusion-induced lung injury in spontaneously breathing cats when administered before ischemia or reperfusion, but not after reperfusion.
嘌呤前体阿卡地新在预防心脏和肠道的缺血再灌注(I-R)损伤方面非常有效。本研究的目的是测试阿卡地新对I-R诱导的肺损伤的影响。在完整胸腔、自主呼吸的猫中,左下肺叶的叶动脉被阻断2小时(第1组,缺血),然后再灌注3小时(第2组,I-R)。动物接受以下三种方案之一:在缺血前15分钟静脉注射阿卡地新(第3组)、再灌注前15分钟(第4组)或再灌注后30分钟(第5组)。阿卡地新的初始剂量为2.5mg·kg⁻¹·min⁻¹,持续5分钟,然后为0.5mg·kg⁻¹·min⁻¹直至再灌注结束。通过组织学检查评估损伤情况。右下叶作为对照。与在任何组中均未发现异常的右下叶(损伤肺泡百分比,2%±1%至4%±2%)相比,I-R组的左下肺叶显示肺泡结构破坏,损伤肺泡为63%±9%。单独缺血未引起肺泡结构改变。在缺血前(4%±1%)或再灌注前(6%±2%)给予阿卡地新可显著减少损伤肺泡数量,但在再灌注后给予则无此效果(62%±8%)。总之,阿卡地新在缺血或再灌注前给予时可减轻I-R诱导的肺损伤。保护作用的潜在机制仍有待阐明。
阿卡地新在缺血或再灌注前给予时可减少自主呼吸猫的缺血再灌注诱导的肺损伤,但在再灌注后给予则无效。